Practice calendar: May

What should a practice do when faced with a request for work experience from a school pupil? A medical defence expert advises

The problem

At this time of year, practices are often asked whether school pupils can obtain work experience within the surgery. Students who are contemplating a career in medicine can benefit from the experience, but agreeing to the request can present significant medico-legal issues. What are the issues, and what should a practice do when faced with such a request?

Expert advice

There is no bar to allowing work experience students to join the surgery, but each case should be judged on its own merits. Students will show different levels of maturity and it is essential to satisfy yourself that you are happy to have the particular student involved.

If it is your practice policy to allow selected students to sit in on some consultations, let all of your patients know - perhaps by placing a notice in the waiting room, explaining why it is valuable experience for the student and that it will only be done with each patient's consent.

The importance of patient confidentiality needs to be impressed upon the student. Once you are satisfied that they are mature enough to understand the duty of confidentiality, ask them to sign a confidentiality agreement.

Decide what elements of the practice's work are suitable for the student to take part in. It may not be appropriate to ask everyone attending the surgery; for instance, young patients close in age to the student may be inhibited or embarrassed by their presence.

Patients have the right to know precisely who the student is and their stage of study, and should be asked for their express consent and told the reason you are asking before the consultation begins. Ideally, ask at the time they make the appointment and again when they check in at the desk. They need to know that they can withdraw their consent at any stage, even during the consultation, and that if they refuse consent this will not in any way affect the care they are given.

Complaints are likely to arise if a patient feels pressurised into agreeing to a student being present, particularly if they feel they have had insufficient warning. Be careful to document their consent. It is also a good idea to record the presence, name and status of a student in the records as if the patient makes a complaint or claim, the student may be called as a witness.

Dr Jacqui Phillips is a medicolegal adviser at the Medical Defence Union